Friday, October 23, 2009

Learn what kinds of peer pressure teens face, who’s most vulnerable, and how to help your son or daughter resist.
Remember when your teenager took her first steps as a toddler? You hovered behind her -- back bent, arms spread -- prepared to catch her should she fall. Much as you might like, you can't shadow your adolescent as you did back then, being there to break her fall when she missteps.

But, say experts, there are steps you can take to support your adolescent in the face of teen peer pressure. Follow them and you'll rest easier when your teen heads out of the house on a Friday night.

Teen Peer Pressure: What's Being Pushed?

So, just what high-risk behaviors might your adolescent feel pressured to engage in? Plenty, according to the Centers for Disease Control and Prevention (CDC), which periodically conducts surveys on health-risk behaviors among youth. The latest survey results indicate that teen peer pressure is real. Many adolescents are engaging in behaviors that place their health at risk -- including cigarette smoking, alcohol consumption, illegal drug use and sexual activity. And in all likelihood, their peers are pushing them to try these behaviors.
Here are some of the survey's findings.Smoking. By the time adolescents are just 13, one in five has tried smoking.Alcohol use. Two-thirds of teens between the ages of 14 and 17 have tried alcohol. Of teen boys who have tried alcohol, 20% did so by the time they were 12. Episodic, or binge drinking, is also fairly common. Of the adolescents aged 12 to 17, one in four said they'd had five or more drinks consecutively within the past month. Almost a quarter of drinkers aged 16 to 21 admitted to driving after drinking.Drug use. Slightly more than 25% of adolescents aged 14 to 17 have used illegal drugs. One-third of young adult marijuana users aged 18 to 21 started using the drug by the time they turned 14.Sex. About one in every three kids aged 14 to 15 has had sexual intercourse. Of sexually active teens, almost 30% used no birth control during their last sexual encounter.
Well-documented risky behaviors aren't the only ones teens may feel pressure to try. Health professionals who work with adolescents report other equally troubling behaviors that may not be as common, but are, nonetheless, on the rise. And they point to teen peer pressure as a culprit.
Consider teens' ardent attempts to emulate unrealistic body ideals. "There's a lot of peer pressure to have your body look a very specific way," says Lauren Solotar, PhD, chief psychologist at May Institute in Massachusetts. While the desire to look "fit and thin" is more pronounced among girls, she notes that many boys as young as middle-school age are on the quest for "six-pack" abs. "It's scary, all the push and the pressure," Solotar says.
Intentional self-injury, in some instances provoked by teen peer pressure, is also on the rise. "It's a method of coping with difficult emotions," says Alec L. Miller, PsyD, chief of Child and Adolescent Psychology at Montefiore Medical Center/Albert Einstein College of Medicine in New York. "There seem to be some peers who are engaging in this behavior [slashing their arms], and persuading others to try it." For example, a survey conducted at Lincoln-Sudbury Regional High School in Massachusetts during the 2004-05 school year, based on the CDC's Youth Risk Behavior Survey, revealed that 20% of high school students had intentionally hurt themselves within the past year.

Identifying Vulnerable Teens

When it comes to determining who will succumb easily to teen peer pressure, there's no single profile.

Some experts say those who are socially adrift are the most likely candidates. "Teens who are prone to social isolation, and have less of a cohesive sense of self, will do things to feel connected," Miller says.

But others say adolescents who seem like the least likely suspects are actually the most susceptible to teen peer pressure. "Popular kids tend to be the most vulnerable. They pay attention to what their peers value. And at 14 or 15, when their peers value experimenting with alcohol, they're going to be right there," says Joseph P. Allen, PhD, a professor of psychology at the University of Virginia.

Why Teens Fall Prey to Peer Pressure

Kids' personal traits aside, many experts agree that simply being of middle-school age is one of the leading causes of peer pressure. "Developmentally, these kids really want to conform," Miller says.
Headstrong children who have known few parental limits in their lives are increasingly vulnerable to peer pressure during the middle-school years. "I see young kids who are strong and willful who have gotten away with a lot," says Michelle M. Forcier, MD, head of adolescent medicine at Children's Memorial Hospital in Chicago. "Then parents suddenly panic because the risk-taking behavior is now about more serious things."
How society is set up also makes adolescents conducive to teen peer pressure, some experts say. "If you go back 40 or 50 years ago, adolescents were much more likely to be integrated with adults, to be more a part of adult society," Allen says. That has changed, he notes, and there's now a much stronger emphasis for teens to socialize with peers. "It's an independent youth culture, where values don't come from parents. There's no real connection to adult values," Allen concludes.

Making Your Child Resilient to Teen Peer Pressure

In spite of adolescents' vulnerability and the strong influence of peers, parents can exert a positive influence on their adolescents' decision-making processes, offering them ways to combat the effects of peer pressure. Experts explain how.

Keep communication lines open
Talk to your kids -- and don't wait until they're teens. Healthcare professionals, counselors, and educators agree unanimously that open communication between parents and their children helps youth better manage teen peer pressure. "It's not too early to have an honest conversation about drugs, sex and other pressures when your child is in fifth grade," Miller says.

Dialogue that starts early pays off in the long run. "The kids who weather the decision-making process are those who can talk to their parents, no matter what the issue, and who know that even if their parents don't approve of it, they will listen and help them make a decision that makes sense to them," Forcier says.

Research supports this theory. Teens who report learning a lot about the risks of drugs from their parents are up to 50% less likely to use drugs than those who say they haven't learned a lot about drugs from their parents. That's according to results of an annual, nationwide survey of teens in grades 6 through 12, conducted by Partnership for a Drug-Free America and reported by Tom Hedrick, senior communications officer and founding member of the association.

Practice peer pressure scenarios
Teen peer pressure may come as a surprise to your child. Out of the blue, he may be offered a cigarette or a swig of alcohol, and he may have no idea how to respond. You can help prepare him for these scenarios. "Find a calm period, prior to or during early adolescence, and role play," Solotar suggests. "It's much easier to manage a situation if you've already thought it out."

Listen to your teen's perspective
Express your personal opinions, but don't let them shut down communication, advises Forcier. "You want to make clear to your adolescent what you believe in. But if you shut down on certain topics, your kid won't come to you as a trusted adult," Forcier says. She offers the example of the parent who adamantly refuses to discuss birth control with her 15-year-old daughter. "These kids are the ones we often end up seeing for pregnancy tests," Forcier says.

Keep inviting your kids into your life
"There is a natural break [between teens and their parents], and it should happen. But I tell parents to keep inviting kids to do things. Kids want their parents to maintain the relationship," Allen says. He warns that it may take some creativity and effort on the part of the parent. "You might have to find new ways to relate to your kid," he says. He suggests trying to find mutual, life-long interests to share with your adolescent, like playing tennis or cooking together.

Think beyond punitive responses
A parent's initial reaction to an adolescent who comes home inebriated may be to punish. But, ultimately, that's not a solution to the real problem. "A punitive response doesn't get at what you need to change the behavior," Forcier says. "If a teen is 14 and she's drinking, there's probably a good reason for it. If you address it, maybe she won't need the alcohol."

Wednesday, October 14, 2009

Eat five small meals a day

Who breaks it Renee Melton, R. D., director of nutrition services for the mobile weight-loss program Sensei."My schedule doesn't give me time to prepare healthy snacks, much less eat them, so I make sure I get what I need in three squares a day."

Why you can, too The "graze, don't gorge" philosophy is based on the premise that having frequent small meals keeps your blood sugar steady, your metabolism ramped up, and your appetite in check. But some studies show a link between obesity and eating more than three times a day, most notably in women. More frequent noshing means more opportunities to overeat. Plus, says Melton, having to constantly think about what you're going to eat can be stressful, especially for emotional eaters.

Do it right To keep hunger pangs from overriding your willpower throughout the day, eat fiber-rich foods at mealtimes—they make you feel fuller and take longer to digest. Shoot for 21 to 25 grams a day, starting with a high-fiber grain cereal like Kashi's GoLean with low-fat milk and fruit. For lunch and dinner, Melton says, fill half your plate with produce, a quarter with carbs, and the other quarter with lean protein.

Avoid white bread, rice, and pasta

Who breaks it Christine Avanti, clinical sports nutritionist and author of Skinny Chicks Don't Eat Salads. She was raised on homemade "white" pasta by her Italian immigrant grandparents.

Why you can, too Carb lovers have long been warned against highly processed products because they're believed to cause a blood sugar spike. But research published in the Journal of the American Dietetic Association found that people on high-carb diets were slimmer than their pastaphobic counterparts even when they threw "bad" carbs like white bread into the mix of fiber-rich whole grains.

Do it right Follow the U. S. Department of Agriculture recommendation of six ounces of carbs each day, and make sure at least half come from whole grains. Then measure out a serving of refined carbs, such as a cup of cooked white pasta, and dig in guilt-free. If a single cup isn't gonna do it for you, pair your pasta with filling protein, like a meaty red sauce made with extra-lean ground turkey.

Don't eat late at night

Who breaks it Ann G. Kulze, M. D., author of Dr. Ann's 10-Step Diet: A Simple Plan for Permanent Weight Loss and Lifelong Vitality. She sits down to dinner every night at 9 p.m. or later.

Why you can, too "A calorie consumed at 9 p. m. isn't handled any differently by your body than one consumed at 9 a. m.," Kulze says. It's less about when you eat than how much you eat. A study published in the European Journal of Clinical Nutrition found that obese women were more likely than svelte women to eat meals late at night, but they were also more likely to eat more, period. And a study by the USDA showed that your metabolism hums along at the same rate no matter how you time your meals. And delaying dinner does have one undisputed advantage: It helps eliminate late-night snacking, one of the worst diet busters.

Do it right One reason you're likely to stuff yourself late at night is that you're ravenous from not having eaten since lunchtime. A healthy snack in the late afternoon (around four if you're planning to eat at nine) can help you avoid this pitfall. Studies have found that the fat in nuts is particularly satisfying, so grab a 100-calorie pack of almonds when you're on the go. When you finally find the time for dinner, actually sit at a table, and nix the distractions. Scarfing a meal in the car or in front of the TV means you usually aren't paying attention to what—or how much—you're eating.

Skip dessert

Who breaks it Judith S. Stern, Sc. D., a professor of nutrition and internal medicine at the University of California, Davis. She has a "few bites of something decadent" when she dines out.

Why you can, too We all discover a little more room beneath our waistbands when the dessert tray rolls by. Studies show that when you're offered a variety of foods, you never achieve what's known as taste-specific satiety; your appetite is stimulated anew as each novel flavor is introduced. Outsmart your taste buds by planning ahead. Stern's trick: She looks at the dessert menu along with the main menu, and if she decides to end the meal with, say, a dark-chocolate tart, she'll always choose a salad dressed in a little olive oil and vinegar to start and then have an appetizer as her entree.

Do it right Desserts are unsurprisingly high in calories, and chain restaurants tend to serve enormous portions—an Applebee's chocolate chip cookie sundae has 1,620 calories and 73 grams of saturated fat! Order off the kid's menu or get something to share. Also consider sorbets and chocolate-dipped fruit, which satisfy a sweet tooth for fewer calories. Dining at home? Try the chocolate raspberry parfait Avanti prepares: Top a half cup of fat-free ricotta cheese with a teaspoon of cocoa powder and a quarter cup of fresh or frozen raspberries. "This snack offers just enough sweetness to calm a sugar craving," she says, "and it's packed with filling protein."

Friday, October 2, 2009

No. 1: Unexplained Weight Loss

Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.
"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.
Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.

No. 2: Bloating

Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.
If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.

No. 3: Breast Changes

Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.

Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.

If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.

No. 4: Between-Period Bleeding or Other Unusual Bleeding

''Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.
Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."
"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three-quarters who get it have some abnormal bleeding as an early sign."
Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.

No. 5: Skin Changes

Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.
If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.

No. 6: Difficulty Swallowing

If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.
But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.
Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.

No. 7: Blood in the Wrong Place

If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."

Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.

Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.

No. 8: Gnawing Abdominal Pain and Depression

Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.

No. 9: Indigestion

Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.
It could be an early clue to cancer of the esophagus, stomach, or throat.
Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.

No. 10: Mouth Changes

Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.
Ask your dentist or doctor to take a look and decide what should be done next.

No. 11: Pain

As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.
Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.

No. 12: Changes in the Lymph Nodes

If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.
"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.
If there are none, your doctor will typically order a biopsy.

No. 13: Fever

If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.

Other cancer symptoms can include jaundice, or a change in the color of your stool.

Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.

No. 14: Fatigue

Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.

No. 15: Persistent Cough

Coughs are expected with colds, the flu, allergies, and sometimes are a side effect of medications. But a very prolonged cough -- defined as lasting more than three or four weeks -- should not be ignored, Mishori says.
You would expect your doctor to take a careful history, examine your throat, check out your lung functioning and perhaps order X-rays, especially if you are a smoker.